哮喘联盟

    肥胖是哮喘的一个危险因素。脂肪组织表达一些促炎因子，包括肿瘤坏死因子（TNF）。TNF水平则与TNFA基因多态性有关。结合两个人群为基础的试验，我们研究了肥胖与TNFA变异性对哮喘的联合作用。欧洲社区呼吸健康调查（ECRHS）和空气污染对瑞士成人肺、心脏疾病影响的队列研究（SAPALDIA）采用类似的方案、问卷以及肺功能和变应性检测。共获取9, 167参与者的DNA并对其进行基因型检测，研究TNFA-308和LTA+252基因变异。经过其独立影响作用的相互校正后，肥胖和TNFA与哮喘相关（肥胖OR为2.4, 95%CI 1.7-3.2；TNFA-308多态性OR为1.3, 95%CI 1.1-1.6）。肥胖与哮喘的相关性在G/A和 A/A TNFA-308基因型个体中要比普通的G/G基因型个体敏感，尤其是在非变应性个体中（G/A和A/A基因型OR为6.1, 95%CI 2.5-14.4; G/G基因型OR为1.7, 95%CI 0.8-3.3; p <0.05）。这些结果首次为肥胖、促炎基因和哮喘之间复杂的联系提供了证据。

（苏楠 审校）
Castro-Giner F, et al. Eur Respir J. 2009 Feb 5. [Epub ahead of print]

Joint effect of obesity and TNFA variability on asthma: two international cohort studies.

Obesity is a risk factor for asthma. Adipose tissue expresses proinflammatory molecules including tumour necrosis factor (TNF), and levels of TNF are also related to polymorphisms in the TNFA gene. We examined the joint effect of obesity and TNFA variability on asthma in adults by combining two population-based studies. The European Community Respiratory Health Survey (ECRHS) and the Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults (SAPALDIA) used comparable protocols, questionnaires and measures of lung function and atopy. DNA samples from 9, 167 participants were genotyped for TNFA-308 and LTA+252 gene variants. Obesity and TNFA were associated with asthma when mutually adjusting for their independent effects (Odds Ratio (OR) for obesity=2.4, 95%CI 1.7-3.2; OR for TNFA-308 polymorphism=1.3, 95%CI 1.1-1.6). The association of obesity with asthma was stronger for subjects carrying the G/A and A/A TNFA-308 genotypes compared to the more common G/G genotype, particularly among non-atopics (OR for G/A and A/A genotypes=6.1, 95%CI 2.5-14.4; OR for G/G genotype=1.7, 95%CI 0.8-3.3; p-value for interaction <0.05).These findings provide for the first time evidence for a complex pattern of interaction between obesity, a proinflammatory genetic factor and asthma.